Oral Contraceptive Use and Clinical Outcomes in Patients with Multiple Sclerosis

Abstract Experimental and clinical data suggest a role of sex steroids in the pathogenesis of multiple sclerosis (MS). Scant information is available about the potential effect of oral contraceptive (OC) use on the prognosis of the disease. We aimed to evaluate this. The study population consisted of 132 women with relapsing–remitting MS before receiving disease modifying treatment and a mean disease duration 6.2 (SD 5.1) years. Three groups of patients were distinguished according to their OC behavior: [1] never-users, patients who never used OC [2] past-users, patients who stopped OC use before disease onset, and [3] after-users, those who used these drugs after disease onset. Multiple linear and logistic regression models were used to analyze the association between oral contraceptive use and annualized relapse rates, disability accumulation and severity of the disease. After-user patients had lower Expanded Disability Status Scale (EDSS) and Multiple Sclerosis Severity Score (MSSS) values than never users ( p p  = 0.002, respectively) and past users ( p  = 0.010 and p  = 0.002, respectively). These patients were also more likely to have a benign disease course (MSSS  p p  = 0.011 and for MSSS β : − 1.04; 95% C.I. − 1.78, − 0.30, p  = 0.006). These results suggest that OC use in women with relapsing–remitting MS is possible associated with a milder disabling disease course.